| NPI | 1255747507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME119202) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME119202) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2019-05-06 |